Abstract
Objective To evaluate the impact of nerve-sparing (NS) approach on outcomes of patients undergoing minimally invasive radical hysterectomy (MRH) for locally advanced stage cervical cancer (LACC). Methods Data of consecutive patients undergoing minimally invasive surgery for LACC were retrospectively retrieved in a multi-institutional setting from 2009 to 2016. All patients included had minimally invasive class III radical hysterectomy (MRH or NS-MRH). Propensity matching algorithm was used to decrease possible allocation bias when comparing outcomes between groups. Results Overall, 83 patients were included. The prevalence of patients undergoing NS approach increased aver the study period (from 7% in the year 2009–2010 to 97% in the year 2015–2016; p-for-trend < 0.001). NS-MRH and MRH were performed in 47 (57%) and 36 (43%) patients, respectively. After the application the propensity-matching algorithm, we compared 35 patients' pair (total 70 patients). Postoperative complications rate was similar between groups. Patients undergoing NS-LRH experienced shorter hospital stay than patients undergoing LRH (3.6 vs. 5.0 days). 60-day pelvic floor dysfunction rates, including voiding, fecal and sexual alterations, were lower in the NS group in comparison to control group (p = 0.02). Five-year disease-free (p = 0.77) and overall (p = 0.36) survivals were similar comparing NS-MRH with MRH. Conclusions The implementation of NS approach in the setting of LACC improves patients' outcomes, minimizing pelvic dysfunction rates. NS approach has not detrimental effects on survival outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 2150-2156 |
| Number of pages | 7 |
| Journal | European Journal of Surgical Oncology |
| Volume | 43 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 1 2017 |
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Keywords
- Cervical cancer
- Laparoscopy
- Neoadjuvant chemotherapy
- Nerve sparing
- Robotic
ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
Introducing nerve-sparing approach during minimally invasive radical hysterectomy for locally-advanced cervical cancer : A multi-institutional experience. / Raspagliesi, Francesco; Bogani, Giorgio; Spinillo, Arsenio; Ditto, Antonino; Bogliolo, Stefano; Casarin, Jvan; Leone Roberti Maggiore, Umberto; Martinelli, Fabio; Signorelli, Mauro; Gardella, Barbara; Chiappa, Valentina; Scaffa, Cono; Ferrero, Simone; Cromi, Antonella; Lorusso, Domenica; Ghezzi, Fabio.
In: European Journal of Surgical Oncology, Vol. 43, No. 11, 01.11.2017, p. 2150-2156.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Introducing nerve-sparing approach during minimally invasive radical hysterectomy for locally-advanced cervical cancer
T2 - A multi-institutional experience
AU - Raspagliesi, Francesco
AU - Bogani, Giorgio
AU - Spinillo, Arsenio
AU - Ditto, Antonino
AU - Bogliolo, Stefano
AU - Casarin, Jvan
AU - Leone Roberti Maggiore, Umberto
AU - Martinelli, Fabio
AU - Signorelli, Mauro
AU - Gardella, Barbara
AU - Chiappa, Valentina
AU - Scaffa, Cono
AU - Ferrero, Simone
AU - Cromi, Antonella
AU - Lorusso, Domenica
AU - Ghezzi, Fabio
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Objective To evaluate the impact of nerve-sparing (NS) approach on outcomes of patients undergoing minimally invasive radical hysterectomy (MRH) for locally advanced stage cervical cancer (LACC). Methods Data of consecutive patients undergoing minimally invasive surgery for LACC were retrospectively retrieved in a multi-institutional setting from 2009 to 2016. All patients included had minimally invasive class III radical hysterectomy (MRH or NS-MRH). Propensity matching algorithm was used to decrease possible allocation bias when comparing outcomes between groups. Results Overall, 83 patients were included. The prevalence of patients undergoing NS approach increased aver the study period (from 7% in the year 2009–2010 to 97% in the year 2015–2016; p-for-trend < 0.001). NS-MRH and MRH were performed in 47 (57%) and 36 (43%) patients, respectively. After the application the propensity-matching algorithm, we compared 35 patients' pair (total 70 patients). Postoperative complications rate was similar between groups. Patients undergoing NS-LRH experienced shorter hospital stay than patients undergoing LRH (3.6 vs. 5.0 days). 60-day pelvic floor dysfunction rates, including voiding, fecal and sexual alterations, were lower in the NS group in comparison to control group (p = 0.02). Five-year disease-free (p = 0.77) and overall (p = 0.36) survivals were similar comparing NS-MRH with MRH. Conclusions The implementation of NS approach in the setting of LACC improves patients' outcomes, minimizing pelvic dysfunction rates. NS approach has not detrimental effects on survival outcomes.
AB - Objective To evaluate the impact of nerve-sparing (NS) approach on outcomes of patients undergoing minimally invasive radical hysterectomy (MRH) for locally advanced stage cervical cancer (LACC). Methods Data of consecutive patients undergoing minimally invasive surgery for LACC were retrospectively retrieved in a multi-institutional setting from 2009 to 2016. All patients included had minimally invasive class III radical hysterectomy (MRH or NS-MRH). Propensity matching algorithm was used to decrease possible allocation bias when comparing outcomes between groups. Results Overall, 83 patients were included. The prevalence of patients undergoing NS approach increased aver the study period (from 7% in the year 2009–2010 to 97% in the year 2015–2016; p-for-trend < 0.001). NS-MRH and MRH were performed in 47 (57%) and 36 (43%) patients, respectively. After the application the propensity-matching algorithm, we compared 35 patients' pair (total 70 patients). Postoperative complications rate was similar between groups. Patients undergoing NS-LRH experienced shorter hospital stay than patients undergoing LRH (3.6 vs. 5.0 days). 60-day pelvic floor dysfunction rates, including voiding, fecal and sexual alterations, were lower in the NS group in comparison to control group (p = 0.02). Five-year disease-free (p = 0.77) and overall (p = 0.36) survivals were similar comparing NS-MRH with MRH. Conclusions The implementation of NS approach in the setting of LACC improves patients' outcomes, minimizing pelvic dysfunction rates. NS approach has not detrimental effects on survival outcomes.
KW - Cervical cancer
KW - Laparoscopy
KW - Neoadjuvant chemotherapy
KW - Nerve sparing
KW - Robotic
UR - http://www.scopus.com/inward/record.url?scp=85029495061&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029495061&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2017.08.015
DO - 10.1016/j.ejso.2017.08.015
M3 - Article
AN - SCOPUS:85029495061
VL - 43
SP - 2150
EP - 2156
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 11
ER -